Spine Journal最新文献

{"title":"Letter to the editor regarding \"Level-specific comparison of 3D navigated and robotic arm-guided screw placement: an accuracy assessment of 1210 pedicle screws in lumbar surgery\" by Asada et al","authors":"Sanaa Hameed MD, Fauziyya Muhammad MD, PhD, Lance M Villeneuve MD, PhD, Zachary A Smith MD","doi":"10.1016/j.spinee.2024.08.031","DOIUrl":"10.1016/j.spinee.2024.08.031","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2428-2429"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications and health-related quality of life following lumbosacral hemivertebra resection and short segmental fusion: a retrospective cohort study","authors":"Haoran Zhang MD , Zhuosong Bai MD , Xiangjie Yin MD, Dihan Sun MD, Shengru Wang MD, Jianguo Zhang MD","doi":"10.1016/j.spinee.2024.08.011","DOIUrl":"10.1016/j.spinee.2024.08.011","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Previous literature has provided descriptions of postoperative complications. However, these studies have included heterogeneous cohorts of hemivertebra patients undergoing different surgical methods and addressing deformities at various locations.</div></div><div><h3>PURPOSE</h3><div>To assess independent risk factors for complications following lumbosacral hemivertebra (LSHV) resection and to further explored the potential association between complications and health-related quality of life (HRQOL).</div></div><div><h3>DESIGN</h3><div>Retrospective cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>We retrospectively analyzed consecutive patients who underwent LSHV resection and short segment fusion at our institution between 2010 and 2022.</div></div><div><h3>OUTCOME MEASURE</h3><div>In the current study, the outcome measure were complications and HRQOL.</div></div><div><h3>METHODS</h3><div>Between 2010 and 2022, a total of 64 consecutive patients with LSHV underwent hemivertebra resection. The diagnostic criteria for LSHV were delineated that the hemivertebra resides caudal to L5 and beyond. Electronic patient record and radiographic data were reviewed retrospectively in our electronic database. According to complications, the patients were divided into with and without complications, and further stratified as neurological, mechanical, and infectious complications. HRQOL outcomes were collected preoperatively, 3 months postoperatively, and at last follow-up using the Scoliosis Research Society-22 (SRS-22) questionnaire. Multivariate logistic regression models were used to determine independent risk factors affecting complications.</div></div><div><h3>RESULTS</h3><div>A total of 64 patients were enrolled in this study for at least 2-year follow-up. The mean follow-up was 7.3±4.2 years. In the coronal plane, the mean main curve was corrected from 27.3° preoperatively to 8.0° postoperatively, and 9.3° at last follow-up. Global spine balance was significantly improved after surgery, and kept stable during the follow-up. In all, 18 complications were recorded in 15 (23.4%) patients. In the multivariate logistic regression model, 3 independent risk factors for complication were screened out, including age (OR=1.16, 95% CI 1.01–1.34, p=.042), anterior reconstruction (OR=3.40, 95% CI 1.03–11.2, p=.045), and preoperative CB (OR=1.06, 95% CI 1.00–1.12, p=.036). The mean SRS-22 total and domain scores for the entire cohort showed improvement at last follow-up. However, in the noncomplication group, the improvements in SRS-22 scores were more substantial.</div></div><div><h3>CONCLUSION</h3><div>Postoperative neurological and mechanical complications are common medical events following LSHV resection. The age, anterior column reconstruction, and preoperative coronal balance were the independent risk factors. Compared to the noncomplication group, the improvements in HRQOL are blunted in the complication group.</","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2400-2406"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world clinical outcomes when discontinuing denosumab or bisphosphonates in patients with surgically managed osteoporotic vertebral compression fractures: a population-based cohort study","authors":"Chuan-Ching Huang MD, PhD , Chih-Chien Hung MD , Ho-Min Chen MS , Jou-Wei Lin MD, PhD , Shau-Huai Fu MD, PhD , Chen-Yu Wang PhD","doi":"10.1016/j.spinee.2024.08.020","DOIUrl":"10.1016/j.spinee.2024.08.020","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Osteoporotic vertebral compression fractures (OVCFs) are common fragility fractures. Patients who undergo surgical treatment for their initial OVCFs warrant particular attention because there is an elevated risk of subsequent vertebral fractures and other types of fragility fractures. However, the optimal osteoporosis treatment for this specific patient group is less investigated.</div></div><div><h3>PURPOSE</h3><div>This study compares the risk of subsequent osteoporotic fractures and mortality rate for patients who are initiated with denosumab and bisphosphonates and determines the effect of adherence to treatment.</div></div><div><h3>STUDY DESIGN</h3><div>Retrospective nationwide cohort study.</div></div><div><h3>PATIENT SAMPLE</h3><div>A total of 2,858 patients who had surgically-managed osteoporotic vertebral compression fractures.</div></div><div><h3>OUTCOME MEASURES</h3><div>The risk of osteoporotic fractures, vertebral fractures, nonvertebral fractures and death.</div></div><div><h3>METHODS</h3><div>This is a retrospective nationwide cohort study that uses the National Health Insurance Research Database. Patients aged ≥50 years who were admitted for surgical interventions for OVCF between 2012 and 2016 and subsequently received denosumab or bisphosphonates for one year were included. Patients were stratified according to their antiosteoporosis medications and adherence to treatment. A multivariable, time-varying Cox proportional hazards model was used to determine the risk of osteoporotic fractures, vertebral fractures, nonvertebral fractures and death.</div></div><div><h3>RESULTS</h3><div>A total of 2,858 patients were included in this study: 1,123 patients in the denosumab group and 1,735 patients in the bisphosphonates group. Compared to persistent denosumab users, the nonpersistent denosumab users, persistent bisphosphonate users and nonpersistent bisphosphonate users had a greater risk of osteoporotic fractures, with respective hazard ratios of 1.64 (95% confidence interval [CI], 1.16–2.32), 1.74 (95% CI, 1.25–2.42) and 1.53 (95% CI, 1.14–2.06). If osteoporotic fractures were divided into nonvertebral and vertebral fractures, none of the groups exhibited an increased risk of vertebral fractures compared to persistent denosumab users, with an HR of 1.00 (95% CI: 0.54–1.88) for nonpersistent denosumab users, 1.64 (95% CI: 0.96–2.81) for persistent bisphosphonate users and 1.52 (95% CI: 0.95–2.43) for nonpersistent bisphosphonate users. However, there was a significantly greater risk of nonvertebral fracture, with respective hazard ratios of 2.04 (95% CI, 1.33–3.11), 1.80 (95% CI, 1.18–2.76) and 1.56 (95% CI, 1.06–2.27) for nonpersistent denosumab users, persistent bisphosphonate users and nonpersistent users. Noteworthy, nonpersistent denosumab users exhibited a significantly greater risk of mortality than persistent denosumab users, with a hazard ratio of 3.12 (95% CI, 2.22–4.38).</div></div><div><","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2366-2376"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The predictive value of intraoperative bulbocavernosus reflex monitoring for postoperative voiding function in patients with conus medullaris and cauda equina tumors: a retrospective single center study","authors":"Xing Fan MD ,&nbsp;Ke Li ,&nbsp;Jiajia Liu MBBS ,&nbsp;Xiao Wu MD ,&nbsp;Yongzhi Wang ,&nbsp;Wenqing Jia MD ,&nbsp;Hui Qiao MMed","doi":"10.1016/j.spinee.2024.08.019","DOIUrl":"10.1016/j.spinee.2024.08.019","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Surgical resection is the preferred treatment in most conus medullaris and cauda equina tumor (CMCET) cases. However, total resection is usually challenging to obtain and has a strong possibility of causing various complications if forcibly attempted. Intraoperative neurophysiological monitoring (IONM) has become a necessary adjunctive tool for CMCET resection.</div></div><div><h3>PURPOSE</h3><div>The current study aimed to evaluate the application value of bulbocavernosus reflex (BCR) monitoring in CMCET surgery.</div></div><div><h3>STUDY DESIGN</h3><div>A retrospective clinical study.</div></div><div><h3>PATIENT SAMPLE</h3><div>The medical records of patients who underwent CMCET resection by the same neurosurgical team at our hospital from September 2020 to June 2022 were retrospectively reviewed. IONM was conducted in all surgeries. According to inclusion criteria and exclusion criteria, ultimately, 105 patients were enrolled in the study.</div></div><div><h3>OUTCOME MEASURES</h3><div>The voiding function was assessed before surgery, 1 month after, and 6 months after surgery using the Neurogenic Bladder Symptom Score (NBSS). If the NBSS obtained 1 month after surgery exceeds 9 points than that before surgery, it can be considered that the patient suffered new-onset postoperative voiding dysfunctions (PVDs). Moreover, if the NBSS could restored (less than 9 points higher than before the surgery) at 6 months after surgery, it was defined as a short-term PVD. Otherwise, it was defined as a long-term PVD.</div></div><div><h3>METHODS</h3><div>The amplitude reduction ratios (ARRs) of bilateral BCR waveforms were calculated and compared between patients with PVDs and those without. The receiver operating characteristic curve analysis was subsequently applied to determine the cut-off value of the maximal and minimal ARRs for predicting PVDs.</div></div><div><h3>RESULTS</h3><div>The maximal and minimal ARRs were significantly correlated with short-term and long-term PVDs (p&lt;.001 for all comparisons, Mann-Whitney U test). The threshold values of maximal ARR for predicting short-term and long-term PVD were 68.80% (AUC=0.996, p&lt;.001) and 72.10% (AUC=0.996, p&lt;.001), respectively. While those of minimal ARR were 50.20% (AUC=0.976, p&lt;.001) and 53.70% AUC=0.999, p&lt;.001).</div></div><div><h3>CONCLUSIONS</h3><div>The amplitude reduction of intraoperative bilateral BCR waveforms showed high predictive value for PVDs.</div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2314-2321"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis of spine pseudoarthrosis based on the biomechanical properties of bone","authors":"John A. Hipp PhD ,&nbsp;Mark M. Mikhael MD ,&nbsp;Charles A. Reitman MD ,&nbsp;Zorica Buser PhD ,&nbsp;Vikas V. Patel MD ,&nbsp;Christopher D. Chaput MD ,&nbsp;Gary Ghiselli MD ,&nbsp;John DeVine MD ,&nbsp;Sigurd Berven MD ,&nbsp;Pierce Nunley MD ,&nbsp;Trevor F. Grieco PhD","doi":"10.1016/j.spinee.2024.08.007","DOIUrl":"10.1016/j.spinee.2024.08.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Failure to fuse following anterior cervical discectomy and fusion (ACDF) may result in symptomatic pseudoarthrosis. Traditional diagnosis involves computerized tomography to detect bridging bone and/or flexion-extension radiographs to assess whether segmental motion is above specific thresholds; however, there are currently no well-validated diagnostic tests. We propose a biomechanically rational approach to achieve a reliable diagnostic test for pseudoarthrosis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;Develop and test a biomechanically based approach to the diagnosis of pseudoarthrosis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;Literature review, development of theory, reanalysis of a previously published study with surgical exploration as the gold-standard, and retrospective analysis of pooled studies to understand time to fusion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Fully automated methods were used to measure disc space strains (change in disc space height divided by initial height). Measurement error combined with the reported failure strain of trabecular bone led to a proposed strain threshold for diagnosis of pseudoarthrosis following ACDF. We reanalyzed previously reported flexion-extension radiographs for asymptomatic volunteers to assess whether flexion-extension radiographs, in the absence of fusion surgery, can be expected to provide sufficient stress on motion segments to allow for reliable strain-based fusion assessment. The sensitivity and specificity of strain- and rotation-based pseudoarthrosis diagnosis were assessed by reanalysis of previously reported post-ACDF flexion-extension radiographs, where intraoperative fusion assessments were also available. Finally, we assessed changes in strain over time using 9,869 flexion-extension radiographs obtained 6 weeks to 84 months post-ACDF surgery from 1,369 patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;The estimated error in automated measurement of disc space strain from radiographs was approximately 3%, and the reported failure strain of bridging bone was less than 2.5%. On that basis, we propose a 5% strain threshold for pseudoarthrosis diagnosis. Reanalysis of a study in which intraoperative fusion assessments were available revealed 67% sensitivity and 82% specificity for strain-based diagnosis of pseudoarthrosis, which was comparable to rotation-based diagnosis. Analysis of post-ACDF flexion-extension radiographs revealed rapid strain reduction for up to 24 months, followed by a slower decrease for up to 84 months. When rotation is less than 2°, the strain-based diagnosis differed from the rotation-based diagnosis in approximately 14% of the cases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;We propose steps for standardizing diagnosis of pseudoarthrosis based on the failure strain of bone, measurement error, and retrospective data. These steps include obtaining high-quality flexion-extension studies, the application of proposed diagnostic threshol","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2407-2416"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence, clinical features, and risk factors for postoperative retropharyngeal hematoma and related dyspnea following anterior cervical discectomy and fusion: a single-center study of 10,615 patients","authors":"Ruomu Qu MD ,&nbsp;Jiyan Jin MD ,&nbsp;Xinrui Wang MD ,&nbsp;Wen Ma MD ,&nbsp;Yanbin Zhao MD ,&nbsp;Shengfa Pan MD ,&nbsp;Xin Chen MD ,&nbsp;Yinze Diao MD ,&nbsp;Xia Tian MD ,&nbsp;Fengshan Zhang MD ,&nbsp;Li Zhang MD ,&nbsp;Shaobo Wang MD ,&nbsp;Yu Sun MD ,&nbsp;Ruifeng Xu MD ,&nbsp;Feifei Zhou MD","doi":"10.1016/j.spinee.2024.08.004","DOIUrl":"10.1016/j.spinee.2024.08.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND CONTEXT&lt;/h3&gt;&lt;div&gt;Postoperative retropharyngeal hematoma (PRH) and related dyspnea are rare but life-threatening complications following anterior cervical discectomy and fusion (ACDF) that require urgent recognition and treatment. However, current knowledge of PRH after ACDF is limited. Meanwhile, whether the morphological features of upper airway are the risk factors of PRH remains unknown.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;The study aimed to investigate the incidence, clinical features, and risk factors, especially the morphological features of upper airway, of PRH and related dyspnea following ACDF.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;A nested case‒control study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;PATIENT SAMPLE&lt;/h3&gt;&lt;div&gt;Consecutive patients who underwent ACDF at a single institute from January 2010 to December 2021 were retrospectively reviewed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OUTCOME MEASURES&lt;/h3&gt;&lt;div&gt;The outcome measures included the incidence, clinical features, intervention, outcome and risk factors for PRH and related dyspnea.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;All patients with PRH were classified into the hematoma group. For each PRH subject, 3 control subjects without PRH were randomly selected as the control group. The clinical features, interventions and outcomes of patients were described. Potential risk factors were evaluated, including demographics, comorbidities, surgical characteristics, coagulation function, blood loss, preoperative blood pressure, and the morphological features of upper airway [prevertebral soft tissue thickness (PVT) and location of transverse arytenoid muscle (TAM) and epiglottis]. Univariate tests and multivariable logistic regression analysis were used to determine the risk factors for PRH. Subgroup analysis was also conducted for PRH patients with and without dyspnea.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Among the 10615 patients who underwent ACDF, 18 (0.17%) developed PRH. The median time from the index surgery to PRH formation was 8.5 hours (25 and 75 percentile: 4 hours to 24 hours). All the PRH patients initially presented with wound swelling. Twelve (0.11%) patients presented dyspnea due to PRH, 2 of whom received urgent intubation and 1 of whom received emergent tracheotomy. All patients underwent hematoma evacuation, and most of them presented with completely relieved symptoms after evacuation, except for 1 patient who died from ischemic hypoxic encephalopathy. A level between the epiglottis and the TAM (LET) greater than 2, ossification of posterior longitudinal ligament (OPLL) and higher diastolic blood pressure (DBP) before surgery were found to be risk factors for PRH formation. Subgroup analysis revealed that a smaller prevertebral soft tissue thickness at C5 was associated with the development of dyspnea.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSION&lt;/h3&gt;&lt;div&gt;This study is the largest study to date focusing on the PRH and related dyspnea after ACDF. Our study showed that the incidences of PRH and relate","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2264-2272"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is orthotic treatment beneficial for fresh osteoporotic vertebral fractures? A propensity score matching study","authors":"Masayoshi Iwamae MD ,&nbsp;Shinji Takahashi MD, PhD ,&nbsp;Hidetomi Terai MD, PhD ,&nbsp;Koji Tamai MD, PhD ,&nbsp;Masatoshi Hoshino MD, PhD ,&nbsp;Yuto Kobayashi MD ,&nbsp;Masayuki Umano MD ,&nbsp;Ryo Sasaki MD ,&nbsp;Masato Uematsu MD ,&nbsp;Hiroshi Katsuda MD ,&nbsp;Nagakazu Shimada MD ,&nbsp;Hiroaki Nakamura MD, PhD","doi":"10.1016/j.spinee.2024.08.002","DOIUrl":"10.1016/j.spinee.2024.08.002","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Orthotic treatment is a common option for the conservative treatment of osteoporotic vertebral fractures (OVF). However, there is insufficient evidence of its clinical benefit.</div></div><div><h3>PURPOSE</h3><div>To investigate the effectiveness of orthotic treatment for OVF.</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>Retrospective cohort study with data from two prospective studies.</div></div><div><h3>PATIENT SAMPLE</h3><div>This study included 160 patients with fresh OVF enrolled in 2012 and 2020 prospective cohort studies.</div></div><div><h3>OUTCOME MEASURES</h3><div>The visual analog scale (VAS) score for low back pain was used for clinical outcomes, and radiographic parameters included the percent height of the vertebra and angular change of the vertebral body. Moreover, the occurrence of secondary vertebral fractures was followed-up over time.</div></div><div><h3>METHODS</h3><div>The patients were divided into brace and no-brace groups and were matched according to propensity score for age, sex, anterior percent height at the initial examination, and presence of old OVFs. Hazard ratio for the cumulative incidence of secondary vertebral fractures with and without bracing were calculated and analyzed using the generalized Wilcoxon test. In addition, the brace group was divided into soft and rigid brace groups and compared with the no-brace group.</div></div><div><h3>RESULTS</h3><div>Each group had 61 cases after propensity score matching. There were no significant differences in the VAS improvement for low back pain and the change in percent height of the anterior and posterior walls from initial examination to 6 months after injury (p=.87, p=.39 and p=.14, respectively, mixed-effect models). Meanwhile, the mean angular change of fractured vertebrae was 4.3° / 3.2° initially and 1.2° / 2.5° at 6 months (the brace group / no-brace group, respectively; p=.007, mixed-effect models). A significant difference was also observed between the rigid brace group and the no-brace group (p=.008, mixed effect models). The incidence of secondary vertebral fractures was 1.6% / 11.4% at 1 month, indicating a significant difference (the brace group / no-brace group, respectively; p=.028). The hazard ratio for the cumulative incidence of secondary fractures due to orthotic treatment was 0.47 (95% confidence interval 0.20–1.09, p=.054).</div></div><div><h3>CONCLUSIONS</h3><div>Although orthotic treatment for fresh OVF did not relieve pain, it might contribute to the stabilization of the fractured vertebra, especially using a rigid brace. Moreover, it might influence a reduction of the imminent vertebral fracture risk immediately after the onset of OVF.</div></div><div><h3>Classifications</h3><div>Clinical study</div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2343-2355"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to letter to the editor regarding “Level-specific comparison of 3D navigated and robotic arm-guided screw placement: an accuracy assessment of 1210 pedicle screws in lumbar surgery”","authors":"Tomoyuki Asada MD PhD,&nbsp;Sheeraz A. Qureshi MD MBA","doi":"10.1016/j.spinee.2024.08.022","DOIUrl":"10.1016/j.spinee.2024.08.022","url":null,"abstract":"","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2430-2431"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of cranium orientation on cervical sagittal alignment during radiographic examination: a radiographic analysis","authors":"Katsuhiro Miyake MD,&nbsp;Takashi Fujishiro MD, PhD,&nbsp;Yuki Yamamoto MD,&nbsp;Yoshitada Usami MD, PhD,&nbsp;Sachio Hayama MD, PhD,&nbsp;Yoshiharu Nakaya MD, PhD,&nbsp;Masashi Neo MD, PhD","doi":"10.1016/j.spinee.2024.08.001","DOIUrl":"10.1016/j.spinee.2024.08.001","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>During the radiographic examination, the cranium orientation varies not only individually but also within the same subject, in different imaging sessions. Knowing how changes in the orientation of the cranium influences cervical sagittal alignment during the radiographic examination of the cervical spine can aid clinicians in the accurate evaluation for cervical sagittal alignment in clinical practice.</div></div><div><h3>PURPOSE</h3><div>To radiographically examine the influence of cranium orientation on cervical sagittal alignment during radiographic examination in an asymptomatic cohort.</div></div><div><h3>STUDY DESIGN</h3><div>A prospective radiographic study.</div></div><div><h3>PATIENT SAMPLE</h3><div>Eighty asymptomatic volunteers (mean age, 40.4 years; 50.0% male) were enrolled.</div></div><div><h3>OUTCOME MEASURES</h3><div>Cervical sagittal parameters including the regional slope (C1 slope, C2 slope, C5 slope, C7 slope, and T1 slope), Cobb angle (O–C1 angle, C1–C2 angle, C2–C5 angle, C5–C7 angle, and C7–T1 angle), and cranial/cervical offset (sella turcica tilt [ST tilt] and C2 tilt).</div></div><div><h3>METHODS</h3><div>In all participants, standing lateral radiographs of the cervical spine were taken in 3 forward-gazing positions: anteverted-cranium (AC) position; neutral-cranium (NC) position; and retroverted-cranium (RC) position. Cervical sagittal parameters, including the regional slope, Cobb angle, and cranial/cervical offset, in these 3 positions were statistically compared.</div></div><div><h3>RESULTS</h3><div>The C1 and C2 slopes were anteverted and retroverted in the AC and RC positions, respectively, compared to those in the NC position. The C5 slope, C7 slope, and T1 slope were constant among the 3 positions. In O–C2 and C2–C5, statistically significant differences in the regional Cobb angles were identified among the 3 positions; however, there were no significant differences in the C5–C7 or C7–T1 segments. Cranial and cervical offsets of ST tilt and C2 tilt increased and decreased when the cranium was anteverted and retroverted, respectively.</div></div><div><h3>CONCLUSIONS</h3><div>The current study suggests that the adjustment of the cranium orientation when taking cervical spine radiographs is mainly controlled at the upper cervical spine of the O–C2 segment in an asymptomatic cohort. On radiograph, alignment in the upper cervical segment of O–C2 changes; accordingly, the middle cervical segment of C2–C5 can change during the adjustment of cranium orientation. However, alignment in the lower cervical segment of C5–C7 and the cervicothoracic junction of C7–T1 remains constant. Further, cranial/cervical offset increases and decreases when the cranium is anteverted and retroverted, respectively. Our results can help the accurate evaluation of cervical sagittal alignment on plain radiographs in clinical practice.</div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2243-2252"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of aerobic and muscle-strengthening activity with chronic low back pain: population-based study","authors":"Yuanpeng Zhu MM ,&nbsp;Haoran Zhang MD ,&nbsp;Qing Li PhD ,&nbsp;Terry Jianguo Zhang MD ,&nbsp;Nan Wu MD","doi":"10.1016/j.spinee.2024.09.009","DOIUrl":"10.1016/j.spinee.2024.09.009","url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Chronic low back pain (CLBP) is a significant global health burden, primarily affecting the middle-aged and older; However, there is a lack of clear, evidence-based guidelines for leisure-time physical activity aimed at preventing CLBP.</div></div><div><h3>PURPOSE</h3><div>This study sought to delineate the association between aerobic physical activity (APA) and muscle strengthening activities (MSA) and the prevalence of CLBP.</div></div><div><h3>STUDY DESIGN</h3><div>This was a population-based study conducted across the United States.</div></div><div><h3>PATIENT SAMPLE</h3><div>This nationwide study utilizes deidentified data from 22 consecutive rounds of the National Health Interview Survey (NHIS) from 1997 to 2018.</div></div><div><h3>OUTCOME MEASURES</h3><div>The primary outcome was self-reported CLBP.</div></div><div><h3>METHODS</h3><div>We analyzed the prevalence of CLBP in a representative sample of 324,793 middle-aged and older people. Among 263,871 individuals, we used multiple logistic regression to investigate individual and joint association between the amount of APA and MSA with CLBP.</div></div><div><h3>RESULTS</h3><div>In total, 263,871 participants (mean age, 59.0 years; SD, 9.7) were included in the final analysis. From 1997 to 2018, the prevalence of CLBP was approximately 32%, with an annual increase. Engaging in APA for 75 to 150 minutes weekly was associated with a modest reduction in CLBP risk (OR [95% CI] = 0.97 [0.97–0.98]). Similar benefits were seen with 150 to 225, 225 to 300, and &gt;300 minutes. Engaging in MSA 2 to 3 times and 4 to 5 times weekly also reduced CLBP risk (0.98 [0.98–0.99] and 0.98 [0.97–0.99], respectively). Optimal reductions of CLBP risk may be associated with balanced levels of APA and MSA, with recommended amounts being 225 to 300 min/w of APA and 4 to 5 times/w of MSA (0.92 [0.89–0.95]).</div></div><div><h3>CONCLUSIONS</h3><div>The study found engaging in over 75 minutes of APA and 2 to 5 weekly MSA sessions is associated with a reduced risk of CLBP. Furthermore, a balanced combination of APA and MSA may correspond to the greatest reduction in CLBP risk.</div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"24 12","pages":"Pages 2207-2217"},"PeriodicalIF":4.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}